Little League Shoulder Can Cause Big Problems Later

May 10, 2004

By Diana Barnes Brown for Shoulder1

A common injury in youth baseball players known as "pitcher’s shoulder" or "little league shoulder" can lead to ongoing problems down the road, says Dr. James Andrews, the Co-Founder of the Alabama Sports Medicine and Orthopedic center and a respected trailblazer in the field of sports medicine.

Many parents associate youth athletics with carefree, family-oriented activities, health-consciousness and – above all – recreation. But the risk of injury for children is just as real for that of adults, and lack of adequate preventative measures during childhood can show up as more serious problems down the road.

At the same time, Dr. Andrews stresses the role of prevention as a favorable option to post-facto treatment: it is "probably the hardest thing we face in sports medicine...during this new decade, we are putting most of our research money into the prevention of injuries." In fact, while many believe that the key to helping children develop their athletic skills is sports participation at an early age - and there is truth to this way of thinking - some children are actually prevented from more substantial participation in college and beyond due to childhood sports injuries that never fully healed.

In youth baseball, there are several factors that coincide to increase the risk of pitcher’s shoulder. Dr. Andrews cites four in particular:

"Number one is year-round baseball: that happens, of course, not only in the sunshine states, but all over the U.S. The second is overuse, for example, playing in more than one league at the same time. The third is the radar gun, where these young kids are trying to throw 92 miles per hour when they're 13 years of age. The fourth risk factor is the showcases, where they go out and try to throw hard, to show off for a college coach or perhaps a pro-scout, and they're not in shape to throw."

Other contributing factors may be the oft-diminished training and sports medicine resources available in community-funded youth sports programs, as well as the lower levels of sports and medical training required of youth sports coaches. Immature skeletal structure can also add to the risk.

So what can concerned parents and caretakers do to prevent their active children from suffering sports injuries? It is helpful for them to learn the injuries common to their child’s sport or sports and communicate with coaches and recreation heads about the precautions that are taken in community, camp, school, and other youth sports venues.

Also, while it is important to encourage children to do their best, pushing them to "just play through" pain or discomfort can be dangerous. As the saying goes, "practice makes perfect," and kudos go to determined athletes, but overuse or ignoring symptoms is as detrimental to ability as lack of practice, especially in growing bodies. Also, while many assume that children have lower pain and fatigue thresholds than adults and that this tendency will act to "self-regulate" injury risks, this is not always the case: some children become so involved in activities they enjoy that they do not notice fatigue or pain in the same way a mature adult would, and it is important for parents and coaches alike to help children set safe limits. Equally important is attention to proper pitching technique, which helps to prevent excessive stress on vulnerable parts of the body and improves ability, as well.

Frequently, even the early stages of injuries can be prevented by well-informed parents, sports coaches and leaders who place emphasis on the importance of proper care, training, and the importance of maintaining a healthy balance between practice and rest.

In the event that symptoms do develop, many sports injury experts suggest the "RICE" regimen when it comes to prevention and treatment: Rest, Ice, Compression with bandages, and Elevation of the affected area. Physical therapy and targeted strength and flexibility exercises can also help to prevent, slow or reverse the development of symptoms, as well as enforcing full-body health and fitness.

While the prospect of injury in young players may give would-be little league parents pause, in reality, proper prevention and treatment can ensure that everyone has a great time – and that no one suffers negative consequences later. "There's a lot that can be done," concludes Dr. Andrews. "That message has not gotten out, but hopefully through media like this, parents and coaches will understand that these injuries begin at a young age. They may not show up until later on, but they begin at a young age."

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